AMY BULLOCK (LCSW) – Clinical Social Worker, NPI 1871997692

AMY BULLOCK (LCSW) is a healthcare provider. based in Heber, California. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 61927 (CA). The NPI Number for AMY BULLOCK (LCSW) is 1871997692

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
AMY BULLOCK (LCSW)
NPI
1871997692
Phone
(760) 540-4335
Address
52 W PHEASANT ST
Enumeration Date
22 October 2014
Last Update Date
22 October 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8434745578
Graduation Year
2017 (9 years ago)
PAC ID
3173054525
Group Practice PAC ID
8628510310
Professional Enrollment ID
I20241009002131
Address ID
CA941071014SA739XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

5,068 CLINICAL SOCIAL WORKER in CA

Provider Addresses for AMY BULLOCK (LCSW)

  • 52 W PHEASANT ST

    HEBER, CA 922499658

    Phone: (760) 540-4335

    Fax: (760) 482-5696

    Type: Mailing

  • 1073 ROSS AVE STE C

    EL CENTRO, CA 922434371

    Phone: (760) 540-4335

    Fax: (760) 482-5696

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-09

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241009002131IClinical Social WorkerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92249)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8628510310View full group profile
NameSpecialtyState
Nurse PractitionerCA
Marriage And Family TherapistCA
Nurse PractitionerCA
Nurse PractitionerCA
Marriage And Family TherapistCA
Marriage And Family TherapistCA
Nurse PractitionerFL
Nurse PractitionerNM
Marriage And Family TherapistCA
Nurse PractitionerFL

Reviews

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Frequently asked questions

What unique ID ties claims to AMY BULLOCK (LCSW)?
NPI 1871997692 is assigned to AMY BULLOCK (LCSW) under the national enumeration system.
Is AMY BULLOCK (LCSW) currently active in the NPI registry?
CMS-published data lists AMY BULLOCK (LCSW) as an active registrant.
Does AMY BULLOCK (LCSW) list a primary specialty?
If you are matching referrals, note Clinical Social Worker for AMY BULLOCK (LCSW). Clinical services aligned with this taxonomy classification.
Where is AMY BULLOCK (LCSW)'s primary listing?
We display Heber, California because that is what the record indicates for AMY BULLOCK (LCSW).
How can I contact AMY BULLOCK (LCSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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